Effectiveness of Psychotherapy

by larc 34 Replies latest jw friends

• 

  larc

  Hi Waiting,

  Regarding the choice of a Psychologiist, here is a list I found.

  Look for:

  1. Someone who has the proper credentials and a state license. As I mentioned somewhere, I was licensed in Ohio and Michigan, but did not practice therapy, because that was not my specialty. By the way, I scored at the 85th percentile on the National Licensing Exam, which means that I scored higher than 84% of the PhD's that took the test.

  I think the best qualification is a PhD or PsyD in Clinical Psych.

  2. Choose someone you find easy to talk to.

  3. Make sure that you are included in the decision making process

  4. Make sure you are comfortable with the type of therapy.

  5. Make sure your values and the values of the therapist are compatable.

  Avoid

  1. A therapist who wants immediate disclosure of intimate material in great sepecificity.

  2. A therapist that talks about themselves too much.

  3. A therapist who distances themselves from you at times.

  4. A therapist who engages in put downs.

  5. Someone who wants a personal, and/or intimate relationship.

  By the way, the stuff on meta-analysis was written that way on purpose, due to an earlier discussion I had on another thread on the subject of factor analysis, with someone who did not have a clue as to what it was about.

  I can explain meta-analysis in simpler terms, if it comes up in your class.
• 

  waiting

  Ahhhhhh, the plot thickens. I was wondering about that there "meta-anaylsis" stuff. Lots of "someone somewhere" notations floatin' round the web at the moment in psychological threads. But to my limited knowledge, the threads here are the only ones talking about theories, studies, therapy. These are good threads.

  I've enjoyed immensely talking with you about psychological theory and studies. The points on this thread and "Social Influences I & II" tie directly into our being inside the WTBTS - why did we do it?

  It helps to understand that the majority of persons presented in these studies are average persons....and they reacted just like us. Not saying it was correct - but we are in the majority - we have lots of company. We have to know ourselves before we can facilitate a change, imho.
  
  As for therapists of any type - I think your points are The Starting Point.....then going, see if one clicks.....or not. It takes a bit of patience and money, of which many people are short on.

  One thing we've not touched upon is the help of Groups and/or Group Therapy. I was in an incest/rape survivor group for about a year. A unique experience. The therapist was a woman, all in the group were women - men were not welcome in there. I asked "what about male rape victims?" The woman said there were cases - but no group in Columbia, SC, at that time. The reason they were not welcome into the women's group was because of the intensity of emotions - and that the man would probably be the target of the women. It was felt it wouldn't be fair to him or the women.

  So the man lost either way he went, so he was just left out. This was about 10 yrs, ago - hopefully it's better now. As for the Group? All agreed it was one of the best they'd been in - I took their word for it, as I was a newbie. Interesting assortment, straight/gay, black/white, rape/incest, quiet/outspoken, funny/suicidal. All were angry - and some had the self-inflicted scars to prove it. Btw, the majority of the women had been in other groups - and said that the "tone" of the therapist & group was all-important. If no "click" - the group didn't tend to last.

  Give Zazu a hug for me!

  waiting
• 

  larc

  Hi Waiting,

  I just finished reading an article by Michael J. Lambert, entitled, The Effectiveness of Psychotherapy. What Has a Century of Research Taught Us About The Effects of Treatment.

  When he discussed the fact that some people are actually harmed by treatment, he put the following in all caps, the only part of his report so written, "This finding suports the need for regulation by state licensing boards, the legislature, and professional associations. This rate of deterioration can be reduced if those governing bodies move to maintain high standards of practice by keeping untrained persons from providing services that require professional judgement and the highest level of ethical practice." Until his recommendation is standard practice, let they buyer beware. There are a lot of quacks out there, as well well meaning people with minimal training.

  Here are some simple and to some degree, some overly simplified definitions of terms that I used.

  Correlation: the relationship between one thing and another. The scale is between zero and 1.0 For example, there is a relationship between height and weight, but not a perfect one, of course.

  Regression: An equation that can predict one thing from another. For example, a regression equation would tell you the average weight for a persons of a particular height.

  Multiple Correlation: The adding up of several things to predict something else. Again, the values range from zero to 1.0. For example, the combination of High School grades and a measure of motivation to learn in college would be a better predictor of college grades than high school grades alone. By the way, the best predictors of job success as identified in Hunter and Schidt's study that I mentioned earlier are the combination of intelligence and integrity.

  Multiple Regression: Combining the several measures to get a number that predicts an outcome. For example, combining measures of high school grades and motivation scores to predict college grades.

  Factor Analysis: A mathimatical method to determine the number of unique things being measured with a large number of things. The method is very useful in developing tests and questionaires. It has been determined that personality tests measure 5 basic factors, called appropriately enough the big 5. It has been determined that many measures of leadership with questionaires measure two basic factors even though the questionaires have hundreds of items.

  Meta-analysis: methods to add up information from many sources to get a better ideas as to what is going on.
• 

  waiting

  heyyyyyyyyyyyyyyyy laaaaaaaaarc,

  Is this the sort of stuff that will be taught in "Statistics"? I've heard through the web grapevine that some of the prettiest drawings are done in that class in an effort to stay awake.

  I've been reading in class about some of the terms you've used, particularily correlations. There are sooooo many terms and people's names to remember. Doing ok.

  I'm watching a good movie - "A Shot in the Dark" about Gary Gilmore, the first man sentenced to be executed in Utah in 1977 (after they brought back the death sentence). About the family violence & cruel family dynamics which involved this Mormon family. Strange and sad.

  waiting
• 

  Lady Lee

  Hi you 2 - nice to see you are both continuing this conversation

  A few years ago I did some research on the problems abuse survivors had in finding professional help. From my persoanl experience I knew it was hard to find someone - at that time any one who knew about incest. It took me 15 years to find some one willing to let me talk about it and the first person was controlling and too motherly for me. In the research I did I discovered that my experience was not unique. Although I realize that there is a lot more awareness out there now than in the past there is still a huge problem in people getting the help they need. A professional credentials are not always the best way to determine how good or effective he/she may be in working with abuse survivors.

  Here is an excerpt from the study - and I am not a researcher by trade - much prefer the counseling end of it.

  ---------

  Thirty-eight (84.44%) of respondents live at or below the poverty line. With such limited resources the possibility of private therapy is inaccessible. In spite of the cost 29 (64.44%) of respondents are presently in therapy and 20 (68.97%) pay between $20-$80 (average $50 per session). Many respondents reported negative experiences with therapists in the past and in some situations these experiences prevented them from seeking further individual therapy. Many of these respondents turned to free self-help groups as an alternative to individual therapy. Survivors reported a range of problems, from mild to severe, with this self-help format.

  Individual Therapy
  Survivors reported on the length of time needed to find suitably trained and supportive therapists (from a few months to 29 years). Many were still looking for help, others could not afford what was available and still others had simply given up trying. Only one respondent stated that she no longer needed therapy. Respondents had collectively seen 164 therapists (average 3.64) and reported that 80 of these therapists were not effective in helping them. Respondents often reported the reactions they received from various therapists while searching for help. Therapists ignored the reports of abuse (n=15), did not believe reports or dismissed them as fantasy (n=8), showed no reaction (n=5), or were very directive (forcing the client into confrontation before they felt ready) (n=3). Therapists often reinforced their clients feelings of being "untouchable", or being "psychologically raped" and of guilt.

  Respondents also reported what was positive about the good therapists they found. Almost every survivor stated that their therapist "supported me" (n=19), "believed me" (n=4), "encouraged me to talk" (n=3), "listened to me" (n=2), "showed empathy" (n=2), "took me seriously", and "encouraged me to talk, remember, feel". A few survivors mentioned that their therapists were knowledgeable.

  Self-help groups
  Thirty-four respondents reported that they have attended a total of 59 self-help groups. Responses to these groups varied widely from "a wonderful & very effective support group" to "the group was totally out of control - a frightening experience." Responses regarding group experiences were more negative than positive. One respondent stated that it felt like "the blind leading the blind". Another stated "the meetings are sometimes disorganized and I do not always get a chance to express feelings". One respondent stated that the group she attended was a "very pretentious, self-centered group. I was totally ignored".

  One respondent who participated in a group with a therapist stated that the therapist was "probing, directive, theatrical, issues skimmed". The therapist "was intent on putting on a good show of how much she could get people to disclose, but she didn't know what to do with it after". Another person stated that she felt forced to talk when she didn't want to. Respondents repeatedly stated that the groups would be better served if there was a trained therapist present to help them deal with issued as they arose and to help organize the group.

  Some groups helped respondents "get more in touch with (my) "feelings", and allowed them to "talk about the abuse openly and honestly". One respondent stated that, "it is of great comfort to be with people who truly understand and unconditionally offer both their friendship and support".

  ------------------------------

  Clearly there are a lot of problem finding good help and sadly those who need the help the most are often the least able to afford it. I have also been in the situation where professionals with a lot more training than I referred their patients to me becuase they knew from experience that I could help many people that they could not. When going to conferences on abuse the consensus seems to be that most often it is the newest professionals, those in still in training and those with the least experience who are most likely to have victims of abuse disclose experiences to them. In Canada most psychiatrists do not do cognitive therapy with their patients. Their business is to diagnose mental disorders and prescribe medications. Many psychiatrists do not know much about PTSD or the treatment modalities used to help victims.

  In my experience both as a professional and as the clinet I have always found social workers or social counselors to be the most informed and best able to help survivors. The psychologists I have met and worked with have rarely been of real help to the people who go to them for help. I sure hope this is changing. And I hope it is a phenomenon that was limited to the area and professionals I knew. And yes I've met my share of bad social workers too.

  Rejoice in the healing and not in the pain.
  Rejoice in the challenge overcome and not in the past hurts.
  Rejoice in the present - full of love and joy.
  Rejoice in the future for it is filled with new horizons yet to be explored. - Lee Marsh 2002